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Reimbursement Issues

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  • Topic: Reimbursement issues
  • Topic: Payment reform
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Report of the National Commission on Physician Payment Reform

March 4, 2013 | Issue Brief

The National Commission on Physician Payment Reform studies new ways to improve patient outcomes, while reining in costs.

Talking with Physicians about Improving Payment and Reimbursement

April 1, 2011 | Report

Report details research conducted to develop and test simple messages that will help local AF4Q leaders begin discussions about payment and delivery reforms with physicians in their community.

Testing PROMETHEUS Payment

September 17, 2012 | Program Result Report

The Health Care Incentives Improvement Institute furthered the development and pilot testing of its Prometheus bundled payment model. Researchers at RAND and the Harvard School of Public Health evaluated the initiative at three pilot sites.

What are Prometheus Payment Evidence-Informed Case Rates?

September 4, 2009 | Issue Brief

This brief explains Evidence-informed Case Rates (ECRs), the core element of the PROMETHEUS Payment model.

Why Does Health Care Cost More in the United States?

September 8, 2011 | Story

RWJF Scholars compare fees for physicians in the United States to other advanced countries —and find they are significantly higher here.

What is PROMETHEUS Payment?

June 10, 2009 | Issue Brief

This brief explains the three essential elements of PROMETHEUS Payment and how it offers a realistic, rational and sustainable blueprint for a new health care payment system.

Physicians' Opinions about Reforming Reimbursement

October 25, 2010 | Journal Article

Most physicians believe that Medicare reimbursements are inequitable but do not agree on how to reform the payment system. Physicians' views may be helpful in optimizing the design of any reimbursement reforms. The researchers of this study solicited their opinions regarding three reform strategies.

Saving Billions of Dollars--And Physicians' Time--By Streamlining Billing Practices

June 1, 2010 | Journal Article

The U.S. system of billing third parties for health care services is complex, expensive and inefficient. This study examines excessive administrative complexity from a focused and potentially practical perspective.

Prometheus Payment

January 1, 2009 | Report

This report describes the PROMETHEUS scorecard approach, the principles of scoring, the sources of the measures, how scores are calculated and the impact on payment.

Building a Bridge from Fragmentation to Accountability

September 10, 2009 | Journal Article

The PROMETHEUS Payment approach seeks to promote and reward high-quality, efficient, patient-centered health care by using a novel method to pay hospitals and physicians and other providers. The PROMETHEUS Payment model consists of three components: evidence-informed base payments with patient-specific severity adjustments and an allowance for potentially avoidable complications.

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